Beyond the L-Strut: Redefining the Biomechanics of Rhinoplasty Using Topographic Optimization Modeling.
Rhinoplasty utilizes cartilage harvested from the nasal septum as autologous graft material. Traditional dogma espouses preservation of the "L-strut" of dorsal and caudal septum, which is less resistant to axial loading than virgin septum. Considering the 90° angle between dorsal and caudal limbs, t...
| Publicado en: | Aesthetic Surgery Journal Vol. 39; no. 12; pp. 1309 - 1319 |
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| Autores principales: | , , , , |
| Formato: | review Journal Article |
| Publicado: |
Oxford University Press / USA
Dec2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=139709074&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 139709074 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1090820X 1XDY jtl: Aesthetic Surgery Journal issn: 1090820X maglogo: N pubinfo: dt: Dec2019 vid: 39 iid: 12 pid: 622 pub: Oxford University Press / USA artinfo: ui: 139709074 139709074 NLM30380010 139709074 10.1093/asj/sjy301 NLM30380010 139709074 ppf: 1309 ppct: 10 formats: tig: atl: Beyond the L-Strut: Redefining the Biomechanics of Rhinoplasty Using Topographic Optimization Modeling. aug: au: Glass, Graeme Ewan Staruch, Robert M T Ruston, Julia East, Charles A Tan, P J affil: Department of Surgery, Sidra Medicine, Doha, State of Qatar sug: subj: Nasal Cartilages Surgery Models, Theoretical Rhinoplasty Methods Finite Element Analysis Autografts Nasal Septum Surgery Kinematics Scales ab: Rhinoplasty utilizes cartilage harvested from the nasal septum as autologous graft material. Traditional dogma espouses preservation of the "L-strut" of dorsal and caudal septum, which is less resistant to axial loading than virgin septum. Considering the 90° angle between dorsal and caudal limbs, the traditional L-strut also suffers from localized increases in internal stresses leading to premature septal "cracking," structural-scale deformation, or both. Deformation and failure of the L-strut leads to nasal deviation, saddle deformity, loss of tip support, or restriction of the nasal valve. The balance between cartilage yield and structural integrity is a topographical optimization problem. Guided by finite element (FE) modelling, recent efforts have yielded important modifications including the chamfering of right-angled corners to reduce stress concentrations and the preservation of a minimum width along the inferior portion of the caudal strut. However, all existing FE studies offer simplified assumptions to make the construct easier to model. This review article highlights advances in our understanding of septal engineering and identifies areas that require more work to further refine the balance between the competing interests of graft acquisition and the maintenance of nasal structural integrity. pubtype: Academic Journal doctype: review Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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